Laparoscopic management of women with a family history of ovarian cancer

Abstract

Background and Objective The safety of laparoscopic surgery in women with a family history of ovarian cancer predicted to have benign disease has not been established. The objective of this study was to evaluate the feasibility and complications of operative laparoscopy and to describe the pathologic findings in this patient population. Methods Sixty‐two consecutive women with a family history of ovarian cancer who elected prophylactic oophorectomy or had predicted benign adnexal disease were offered laparoscopic surgery. Patient characteristics, details of laparoscopic surgery, operative and postoperative complications, and histopathologic findings were recorded. Results Laparoscopy was converted to laparotomy in 2 patients (3.2%); 1 patient (1.6%) had an operative vascular complication, and 1 patient (1.6%) had postoperative bleeding. Median (range) estimated blood loss, operative time, and hospital stay were 50 ml (50–1,500), 120 min (60–290), and 1 day (0–9), respectively. Histopathologic findings included normal ovaries (n = 20), corpus luteum cyst (n = 16), follicular cyst (n = 8), endometriotic cyst (n = 7), serous cystadenoma (n = 5), epithelial hyperplasia (n = 4), dermoid cyst (n = 1), and fibrothecoma (n = 1). Conclusions Laparoscopic surgery is feasible and safe in women with a family history of ovarian cancer predicted to have benign disease and is associated with low blood loss and short hospital stay. Most ovaries removed are either normal or have benign disease. J. Surg. Oncol. 1999;72:9–13. © 1999 Wiley‐Liss, Inc.

Uptake and timing of bilateral prophylactic salpingo-oophorectomy among BRCA1 and BRCA2 mutation carriers

“…6 -8 In addition, surgical morbidity and mortality has decreased with the advent of laparoscopic surgical techniques. 9 Thus, BSO is currently recommended to BRCA mutation carriers between 35 and 40 years of age or at completion of childbearing. 5,10 Despite this, many women and clinicians are concerned about the effects of premature menopause after surgical prophylaxis.…”

Perioperative outcomes using LigaSure™ compared to conventional bipolar instruments in laparoscopic salpingo-oophorectomy: a randomized controlled trial

“…Reported mean operating time varied between 60 and 70 min and mean reported blood loss was 50 mL [13,14]. These studies did not take into account the level of experience of the first surgeon.…”

“…We considered a difference of 15 min in operating time to be clinically relevant. We assumed a standard deviation of 25 min, as earlier reported standard deviations varied between 17 and 35 min [13,14]. Using Student's t-test, two-sided, and considering a dropout rate of 10 %, 97 patients should be randomized to achieve a power of 80 % at a 5 % significance level.…”

The Role of Prophylactic Oophorectomy in the Management of Hereditary Breast & Ovarian Cancer Syndrome

“…However, the last decade has seen an increase in the laparoscopic approach to hysterectomy which has been successfully employed for endometrial and cervical malignancy with comparable surgical and oncologic outcomes to laparotomy (Cho et al, 2007;Eltabbakh et al, 2000). Laparoscopic vaginal hysterectomy combined with laparoscopic PSO is a feasible minimally invasive approach to risk reducing surgery in patients with BRCA1/2 mutations (Casey et al, 1998;Eltabbakh et al, 1999). Recent advances have seen the development of an even less invasive approach to laparoscopic surgery known as laparoendoscopic single-site surgery (LESS).…”